title: Symptomatic myoma treated with laparoscopic uterine vessel occlusion and subsequent immediate myomectomy: which is the optimal surgical approach?
abstract: OBJECTIVE
  To determine the optimal surgical approach when patients are treated with laparoscopic uterine vessel occlusion (LUVO) combined with myomectomy in the management of women with symptomatic uterine fibroids.
  
  
  METHODS
  An observational study.
  
  
  METHODS
  Medical centers.
  
  
  METHODS
  One hundred thirty-one patients with symptomatic myomas underwent LUVO plus laparoscopic myomectomy (LM; LUVO+LM) (n = 49) or LUVO plus ultra-mini laparotomy UMLT-M (LUVO+UMLT-M) (n = 82).
  
  
  METHODS
  Myomectomy through laparoscopy or UMLT access.
  
  
  METHODS
  The outcome was measured by comparing surgical techniques, and 3-year follow-up, including symptom control and reintervention (hysterectomy or myomectomy), in both groups.
  
  
  RESULTS
  General characteristics of the patients were similar in both groups, except the number of myomas. Surgical techniques seemed to be easier in the LUVO+UMLT-M group than in LUVO+LM group, because of less operation time (56.1 +/- 16.9 minutes vs. 73.4 +/- 26.9 minutes; P=.009) and a higher success rate (100% vs. 91.8%; P=.018). There were no differences in the 3-year follow-up of the therapeutic outcomes of the LUVO+UMLT-M and LUVO+LM groups, with low reintervention rates (1.2% vs. 0) and good symptom control rates in both groups.
  
  
  CONCLUSIONS
  The LUVO+LM, either through laparoscopy or UMLT, was acceptable in the management of symptomatic uterine fibroids. However, the LUVO+UMLT-M technique might be more feasible, as it required less operative time and had a higher success rate.
authors.affiliation: Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine and Taipei Veterans General Hospital, Taipei, Taiwan. phwang@vghtpe.gov.tw
authors.forename: Peng-Hui
authors.initials: PH
authors.lastname: Wang
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Liu
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.forename: Hsiang-Tai
authors.initials: HT
authors.lastname: Chao
authors.forename: Chiou-Chung
authors.initials: CC
authors.lastname: Yuan
authors.forename: Kuan-Chong
authors.initials: KC
authors.lastname: Chao
mesh_terms: D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007889:Leiomyoma / Q000175:diagnosis / Q000601:surgery*; D009214:Myoma / Q000175:diagnosis / Q000601:surgery*; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014599:Uterus / Q000098:blood supply* / Q000601:surgery*